Healthcare Provider Details

I. General information

NPI: 1780519660
Provider Name (Legal Business Name): FABIENNE OUAPOU-LENA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5467 9TH ST
KEYES CA
95328-9771
US

IV. Provider business mailing address

5467 9TH ST
KEYES CA
95328-9771
US

V. Phone/Fax

Practice location:
  • Phone: 925-595-5825
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number95267368
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9561442
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: